Individual
JEAN MADINGER JOHNSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
154 COMMACK RD, COMMACK, NY 11725-3457
(631) 499-8282
(631) 462-5462
Mailing address
154 COMMACK RD, COMMACK, NY 11725-3457
(631) 499-8282
(631) 462-5462
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
165968
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01747382
—
NY
01
—
457X21
EMPIRE BCBS
—
01
—
CP502
OXFORD
—
Enumeration date
11/07/2006
Last updated
01/04/2010
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